热奄包穴位外敷对混合痔术后尿潴留患者疼痛、排尿功能和膀胱尿动力学的影响  

Effects of Reyanbao(热奄包)External Application of Acupoints on Analgesia,Voiding Function and Bladder Urodynamics in Patients with Postoperative Urinary Retention after Mixed Hemorrhoids

作　　者：代立霞 赵婉琳 赵志强[1] DAI Lixia;ZHAO Wanlin;ZHAO Zhiqiang(Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang Hebei 050000,Chain)

机构地区：[1]石家庄市中医院,河北石家庄050000

出　　处：《中医药导报》2023年第6期101-105,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：河北省中医药管理局科研计划项目(2020331)。

摘　　要：目的:探讨热奄包穴位外敷对混合痔术后尿潴留患者疼痛、排尿功能和膀胱尿动力学的影响。方法:选择80例混合痔患者为研究对象,随机分为两组,试验组和对照组各40例。所有患者均住院治疗,并行混合痔外剥内扎术,术后给予相同的对症治疗方案,包含创面清洁、消肿、抗感染等,对照组患者给予术后静脉滴注七叶皂苷钠,试验组给予静脉滴注七叶皂苷钠联合热奄包穴位外敷治疗,两组患者均连续治疗3 d。疗程结束后对比疗效。对比两组患者干预后恢复排尿时间、排尿量、残余尿量;对比两组患者术后第1天和疗程结束后的疼痛情况,包含VAS评分、血清5-羟色胺(5-HT)、前列腺素E2(PGE2)、一氧化氮(NO)水平;对两组患者治疗前后排尿功能和尿动力学进行检测,检测内容包含最大尿流率(Qmax)、残余尿量(RV)、首次尿意膀胱容量(FDV)及逼尿肌压力。结果:试验组治疗总有效率为95.00%(38/40),明显高于对照组的80.00%(32/40)(P<0.05);疗程结束后两组患者VAS评分及血清5-HT、PGE2、NO水平均明显低于术后第1天(P<0.05),且试验组患者VAS评分及血清5-HT、PGE2、NO含量明显低于对照组(P<0.05);疗程结束后两组患者Qmax和逼尿肌压力均明显高于术后第1天(P<0.05),且试验组患者Qmax和逼尿肌压力明显高于对照组(P<0.05);疗程结束后两组患者RV、FDV均明显低于术后第1天(P<0.05),试验组患者RV、FDV明显低于对照组(P<0.05)。结论:热奄包穴位外敷可对混合痔术后尿潴留患者有效镇痛,减轻机体疼痛介质含量,降低应激水平,同时增强患者排尿功能并改善膀胱尿动力学,具有较好的疗效。Objective:To investigate the effects of Reyanbao external application of acupoints on analgesia,voiding function and bladder urodynamics in patients with postoperative urinary retention after mixed hemorrhoids.Methods:Totally 80 patients with mixed hemorrhoids were selected as the research subjects of this prospective study.The 80 subjects were divided into control and treatment groups,40 cases in each group.The grouping method was randomized.All patients were hospitalized in our hospital and underwent mixed hemorrhoid excision and internal ligation.The same symptomatic treatment plan was given after operation,including wound cleaning,detumescence,anti-infection,etc.The control group was given intravenous infusion of sodium aescinat after operation.The treatment group was given intravenous infusion of sodium aescinat combined with Reyanbao external application of acupoints.And the patients in both groups were treated continuously for 3 days.The curative effect was compared after the course of treatment.The recovery time of urination,urination volume and residual urine volume were compared between the two groups after intervention.The analgesia on the 1st day after the operation and at end of the course of treatment,including VAS score,serum 5-hydroxytryptamine(5-HT),prostaglandin E2(PGE2)and nitric oxide(NO)content,were compared between the two groups.Voiding function and urodynamics were tested,including maximum urinary flow rate(Qmax),residual urine volume(RV),first-time urinary bladder volume(FDV),and detrusor pressure.Results:The total effective rate was 95.00%(38/40)in treatment group and 80.00%(32/40)in control group.The treatment group showed higher total effective rate than control group(P<0.05).After the course of treatment,the VAS scores and serum 5-HT,PGE2 and NO contents were significantly lower than those on the first postoperative day in two groups(P<0.05).The treatment group showed lower VAS score and serum 5-HT,PGE2 and NO contents than control group after treatment(P<0.05).After the course of tre

关 键 词：混合痔 混合痔外剥内扎术 尿潴留 热奄包 穴位贴敷 排尿功能 膀胱尿动力学 临床研究 

分 类 号：R266[医药卫生—中医外科学]